Griffin Works offers Pawsitive Interactions with Service Dogs During Response Operations©, an audience-customized training that breaks down barriers by offering hands-on handling training and demonstrations with working service dogs for fire departments, EMS agencies, and public safety organizations.

Part of the National Domestic Preparedness Consortium and home to the National Emergency Response and Recovery Training Center, TEEX has been leading homeland security training since 1998. The major TEEX programs include fire and rescue, infrastructure and safety, law enforcement, economic and workforce development, and homeland security. As a member of The Texas A&M University System, TEEX is unique in its ability to access a broad range of emerging research and technical expertise. Beginning with course design and development all the way through hands-on instruction and national certification testing, TEEX delivers comprehensive training through both classroom and hands-on instruction and as online courses.

The National Child Traumatic Stress Network (NCTSN) was created by Congress in 2000 as part of the Children’s Health Act to raise the standard of care and increase access to services for children and families who experience or witness traumatic events. This unique network of child-serving professionals, caregivers and young adults, researchers, and national partners is committed to changing the course of children’s lives by improving their care and moving scientific gains quickly into practice across the U.S. The NCTSN is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA) and coordinated by the UCLA-Duke University National Center for Child Traumatic Stress (NCCTS). 

The Emergency Management Institute (EMI) is part of the Department of Homeland Security’s Federal Emergency Management Agency (FEMA). The EMI provides national leadership in developing and delivering training to ensure that individuals and groups having key emergency management responsibilities possess the requisite skills to effectively perform their jobs.

The High Alert Institute maintains a list of reviewed courses provided by governments, universities and professional organizations. This list is geared towards the non-emergency management person who participates in disaster planning, preparedness, response, recovery or mitigation as part of their job responsibilities.

The High Alert Institute has partnered with Shutterstock to distribute stock images from the nature images donated by our supporters. For eligible stock images, Shutterstock will donate a portion of the royalty to the High Alert Institute. There is no cost to charitable organizations or to Shutterstock customers.

For eligible purchases through AmazonSmile, the AmazonSmile Foundation will donate 0.5% of the purchase price to the High Alert Institute. There is no cost to charitable organizations or to AmazonSmile customers. All you need to do is push the SMILE NOW button and select to support THE HIGH ALERT INSTITUTE on AmazonSmile.

Koi need forever homes, too! For pond enthusiasts, freshwater exotic and ornamental fish may not be available through pet stores or rescues in their area. The High Alert Institute Aquatic Pet Shelter Rehoming Program will be happy to assist you in stocking your new pond or adding a new finned friend to your school. Coming soon – when you adopt a Koi from the High Alert Institute Aquatic Pet Shelter Rehoming Program, we can arrange for delivery to your door anywhere in the continental United States.

Have you always wanted a Koi pond but don’t have the space one? Sponsor a Koi in our community shelter pond and we send you photos of your sponsored animal. Coming soon are live Koi Cameras above and below the water to enjoy your sponsored Koi anytime.

Dumping of freshwater non-native species and exotic aquatic pets into wild habitats is a man-made disaster that is truly preventable. The Institute’s Aquatic Pet Welfare Partnership works to raise awareness and reduce the impact on healthy ecosystems through education, as well as rescue and rehoming. Joined by champions of animal welfare and environmental stewardship, this  association of aquatic pet rescue operations and aquatic pet shelters across the United States aims to save our finned friends and preserve our waterways together.

Want to share our cause with family, friends, and colleagues? Looking for a non-traditional way to celebrate a birthday or honor someone special? Support the Institute by starting your own Peer-to-Peer fundraising challenge! Let your contacts know why our mission is important to you and what they can do to support your cause. START YOUR OWN FUNDRAISER for the High Alert Institute.

From the staffing pool to the shelter ponds, from the boardroom to the classroom, and from reading the science to writing the analyses, High Alert Institute programs and services benefit from the experience, expertise, and generosity of our volunteers. Put your talents to use for good and to good use – VOLUNTEER TODAY.

Make your donation twice as nice by rehoming aquatic pets and providing a rehabilitation companion pet to a deserving person, family, or facility. Sponsor part or all of a Joy of Koi Program pond installation – complete with rehomed koi – and give the gifts of love and recovery.

Professional photographers, amateurs, and legal copywrite holders are all welcome to participate in the High Alert Institute Nature Photo Donation Program. Sales of the images benefit the Institute and donors are eligible for tax deductions equivalent to the fair market value of their photos. Landscapes, seascapes, animals, flowers – all may be accepted – whether new or vintage  images. People may be included in the photo but only if unidentifiable (i.e., blurred figures at a distance).

Did you know that unused patents and copyrights can be donated to charity? Intellectual Property (IP) just sitting on a shelf will lose value as it becomes obsolete. The High Alert Institute IP Donation Program seeks to rescue stranded, technology-related IP with the potential for development into marketable products. Once accepted by the program, the owner/inventor is eligible for a tax deduction equivalent to the fair market value of the IP. The Institute receives the patent licensing fees or revenue from the sale of the IP to businesses, helping us to fund our mission. In turn, businesses are able to advance their markets and create jobs for less money than starting a project from scratch.

Disasters are defined as situations in which needs exceed or overwhelm available resources. Some disasters affect an entire community, while other disasters impact individuals and families. Crises of physical or psychological health can be very personal disasters.
The therapeutic value of pets during illness, trauma, and recovery is well established. And Koi fish may be well suited for people who are not able to provide verbal pet commands or physically care for pets like dogs and cats. Koi ponds are also a source of beauty and peace, providing an ideal setting for quiet reflection or meditation.
We are working to partner with pond installers and aquatic pet rescues/shelters to offer free or reduced-cost ponds with rehomed Koi fish to people seeking this type of pet therapy.

Disasters disrupt life and impact our sense of personal, family, and community safety. Survivors and responders alike often are not aware of the emotional, psychological or spiritual challenges that they may face from disaster onset through recovery. With two decades of experience training responders and communities to prepare for the behavioral health aspects of disasters, we will continue to provide education and a curated list of resources to groups or individuals.

Non-medical factors that impact overall health are termed Social Determinants of Health or SDoH. Noise pollution, poor air quality, and poor water quality are three environmental factors known to have a strong link to overall health. And the same environmental factors that impact humans impact their pets and other animals in their care. We continue to assist in advocacy, education, and technology development to mitigate the impact of SDoH on humans and animals alike.

Our efforts in shelter and rescue are the main focus of our environmental stewardship, reducing the environmental impact of non-native aquatic animals being dumped into public waterways. The High Alert Institute also assists innovators with the design, development, and evaluation of green and renewable energy technologies. Reducing the carbon footprint associated with disaster preparedness, response, and recovery furthers our continued mission to mitigate risk and improve resilience.

We partner with public and private organizations, sharing resources and fostering partnerships to improve disaster preparedness, response, and recovery, and mitigation.

The High Alert Institute team has over a century of combined research experience in medical, nursing, behavioral health, and disaster sciences. Our team provides support to researchers and technology developers through comprehensive literature searches and reviews, as well as failure mode database searches and adjudicated reviews.

When disaster strikes, most aquatic pet owners have limited options to secure the safety of their pets. Sheltering in place may not be possible if there is no power to provide aeration and “pet-friendly” shelters do not include ponds or aquariums. Our goal is to provide an option for aquatic pet owners in need of rescue and shelter for their finned friends.

Our goal is to share our two decades of disaster readiness experience with animal welfare organizations, shelters, caretakers, and pet owners, as they implement contingency  plans for natural and manmade disasters.

High Alert Institute



Doc My Head Hurts

by | May 21, 2008

“Doc, my head hurts!”


Every emergency room doctor hears these works every time they work. Although most headaches are no more than just that, a headache, the rare headache that is more can be a medical catastrophe for the patient, their family and their doctor. Doctors are expected to consider and eliminate the causes of headache that could be dangerous, but headache patients want their pain taken away.


What’s in the Doctor’s Head

Every doctor, from their medical school days, is taught to fear headaches that belie a fatal condition. Doctors are conditioned to interpret every severe headache as a possible ruptured aneurysm and nothing defines a headache as severe like the willingness to wait for hours in an ER waiting room.


Once doctors are in practice, they encounter the patients that they fear even more than those with bleeding in their brains. Patients seeking one form of secondary gain or another (attention, narcotic medications, time off work) visit emergency rooms because discovery of their motives is less likely because there is no continuity of care. Each ER visit is a different doctor and a new chart. 


Over time, headache becomes associated in the mind of the ER doctor with skullduggery. This places the doctor in a quandary, torn between the concern for serious disease (aneurysm) and suspicion over motives fro coming to the emergency room at all. 


What’s in the Patient’s Head

Over the years, many theories have been posited for what causes headache and migraine. The most current science indicates that headache and migraine are most often caused by activation of an area of the brain referred to as the “migraine generator.” This area exists in both the left and right side of the brain near the trigeminal ganglia. A headache can occur when either or both “generators” are active. The “migraine generator” creates chaotic signals causing pain.


What if it is not a simple headache or migraine? Serious causes of headache include not only aneurysm, but infection and injury. Aneurysms leak blood intermittently (sentinel bleeds) which are a form of warning headache. Eventually the aneurysm ruptures and bleeds into the brain. When this occurs, the headache is commonly described as the worst headache of the patient’s life. Headaches from bleeding aneurysms begin so suddenly, they are known as “thunderclap” headaches.


Infections such as meningitis and encephalitis are serious and life threatening contagious diseases that cause not only headache but fever, stiff neck and sometimes even a rash. These infections are so contagious that when suspected, everyone exposed to the patient is placed on antibiotics to prevent additional infections from occurring.


The emergency room doctor discovers these serious causes for headache with a combination of medical history (questions), CT scans of the brain and spinal tap. Many patients fear and even refuse the spinal tap because it involves a needle in the back, but even the best medical history and CT scans can only find 87% of the serious and fatal causes of headache. Spinal tap brings this to over 99%. 


How Best to Get Rid of the Pain

The goal of going to the ER for a headache is to relieve the pain, but the treatment that patients most want (even demand) is the treatment most likely to cause another headache.  Studies over the past three decades have demonstrated that narcotic pain medication (morphine, meperidine, butabutol, codeine, etc) and even non-narcotic pain medication (acetaminophen, aspirin, ketorolac, etc) cause “rebound headache.” 


So how should a headache be treated?


The International Headache Society (IHS) is the professional organization dedicated to the study of the treatment of headache. IHS has published guidelines for headache based on the type of headache treated. Unfortunately it is often difficult or impossible, in a single ER visit, to narrow the diagnosis as tightly as the IHS guidelines would like. Instead, the enlightened ER doctor uses a combination of the first choice recommendations for headache and migraine from each broad category of headache. The combination looks like this:


First Medications (one of the following):

  • Tryptan Medications (Imitrex, Maxalt, etc)
  • Prochlorperazine (Compazine)
  • Metoclopramide (Reglan)


Adjunct Treatments (both):

  • Supplemental Oxygen
  • Intravenous Fluids


But Doc My Head Hurts

When the headache is severe, worse of life and/or thunderclap in onset, patients going to the emergency room seek to ensure their own health and have pain relieved. Most headaches and migraines respond well to the IHS guideline treatments, but on rare occasions, true headache and migraine are resistant to these therapies. In these rare cases, the IHS guidelines state that conservative narcotic pain medication as “rescue therapy” is acceptable. Given these guidelines, this narcotic prescription should never be the first, second or even third treatment option chosen and when considered, the patient should receive full disclosure of the likelihood of rebound headache. 


The decision to resort to narcotic pain medication in headache and migraine is a clinical decision. The incidence of migraine in the general population is far less than the incidence of headache and migraine as a presenting emergency room complaint. Given adequate conservative therapy, the prudent emergency room physician may opt to reserve further therapy given symptoms out of proportion to complaint, patient resistance to adequate evaluation and other factors. Conversely, the prudent emergency room physician may opt to employ rescue therapy despite limited clinical information.


Regardless of the patient presentation and clinical situation, headache and migraine will remain one of the best tests of the physician’s ability to meld the art and the science of medicine.

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High Alert Institute

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